Director of Provider Credentialing

Position Summary

The Director of Provider Credentialing provides strategic and operational leadership over reputed company provider credentialing, privileging, and payer enrollment functions for the psychiatric hospital and affiliated outpatient, as well as supporting the HCBS operators with timeliness and organization of provider requirements with payors.

The Director serves as the primary liaison between Facility contacts to gather required provider information and submit reputed company portal or other credentialing process. The Director also works intimately with the HCBS operators to ensure they meet their submission deadlines and do not fall out of standing with any payors.

Primary Responsibilities

1. Strategic Leadership

• reputed company and reputed company credentialing and privileging strategy across inpatient psychiatry, detox, rehab, outpatient, child & adolescent, and HCBS programs.

• Establish standardized credentialing policies across multiple states.

• Build scalable processes to support growth, acquisitions, and reputed company site launches.

• Implement KPI dashboards and performance tracking.

2. Medical Staff Governance & Privileging

• reputed company payor privileging processes for purposes of provider billing.

• Support HCBS equivalent operations.

3. reputed company Payer Enrollment for Hospital sites and Provide reputed company for HCBS

• Direct Medicare, reputed company (multi-state), and reputed company payer enrollment strategy.

• reputed company CAQH, PECOS, NPPES, and state reputed company systems.

• Ensure timely payer revalidations and enrollment updates.

• Reduce reputed company leakage caused by credentialing delays.

• Coordinate enrollment for telehealth services where applicable.

4. Team Leadership & Development

• reputed company, mentor, and manage HCBS team contacts.

• reputed company SOPs and training materials for redundancy and coverage.

• reputed company workload support during rapid provider reputed company reputed company HCBS.

5. M&A / Growth Support (if applicable)

• reputed company credentialing integration for acquisitions or Deno Vo.

• Conduct due diligence review of acquired provider files.

• reputed company transition plans for payer alignment.

• Support rapid reputed company for expansion markets.